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GPHC team successfully addresses rare defect in newborn
Kaieteur News – Conducting another groundbreaking surgery, Chief Neurosurgeon at the Georgetown Public Hospital Corporation (GPHC), Dr. Amarnauth Dukhi led a multi-disciplinary team on September 30, last, that successfully removed a rare neural tube defect from an 11-day-old baby girl.
Chief Neurosurgeon at Georgetown Public Hospital Corporation (GPHC), Dr. Amarnauth Dukhi (left), alongside baby Shailah Persaud and her parents. (Photo Credit: GPHC)
The baby, Shailah Ariya Persaud, was born on September 19, 2022 at the Suddie Hospital to Altia Atkinson, a 34-year-old housewife, and Satesh Persaud, a 41-year-old carpenter, both of Reliance, Essequibo Coast.
Dr. Dukhi and his team who operated on little Shailah at the GPHC. (Photo Credit: GPHC)
The GPHC in a release revealed that when Atkinson, a mother of five found out that she was pregnant, she sought prenatal care at her community health centre where her ultrasounds appeared normal and showed no cause for concern.
It was not until she was admitted for the delivery of her sixth baby that her ultrasound showed some irregularity. However, physicians at the Suddie Hospital were unable to determine if the mass they were detecting was growing on Atkinson or her unborn child.
Following a caesarean section operation on September 19, the baby was immediately referred to the GPHC on account of a malformation that presented as a second head. There she was reviewed by Chief Neurosurgeon, Dr. Dukhi, who quickly diagnosed her with a neural tube defect.
After a number of MRI scans of the brain and cervical spine was done, Dr. Dukhi had confirmed a rare Cranio- Cervical Junction malformation, which is a combination of the neural tube defects of the brain and spine as one, a Myelomeningocele-encephalocele occurring at the back of the head where the brain joins the spinal cord, the release explained.
The mass that was removed surgically from the baby on September 30, last. (Photo Credit: GPHC)
The GPHC noted that while neural tube defects are quite a common birth defect, they usually occur on the head or the spine separately. In fact, the occurrence of encephalocele and myelomeningocele together as one defect in the same patient is rarely described in medical literature, the hopital revealed. In these uncommon cases, the hospital noted, the neural tube defect presents as a sac-like protrusions on the brain and spine and are caused by the failure of the neural tube to close completely during foetal development, which may be attributed to several internal and external factors, mainly lacking the use of Folic Acid during pregnancy.
The release further stated that the management of encephalocele and myelomeningocele is often associated with numerous challenges including blood loss, cardio-respiratory disturbances and hypothermia. Surgical intervention is critical to prevent hemodynamic fluctuations and excessive pressure on the sac which may result in premature rupture and eventual death.
Dr. Duki and his team on September 30, last, separated the large malformation and repaired the defect at the junction where the brain and spinal cord are joined.
The GPHC noted that this tedious and complicated medical intervention for the new-born commenced firstly with the placement of VP shunt for the developing hydrocephalus that was also diagnosed.
The large malformation, the hospital described, was the size of the normal head which was then carefully separated from the head and upper cervical spine of the baby. This procedure was then followed by the reconstruction of the cranio-spinal junction’s defect to prevent the leakage of cerebrospinal fluid and allow for normal development of brain and spinal structures.
The operation, which was deemed a successful one, lasted for more than six hours.
After spending seven days in the hospital’s neonatal post-operative care unit, the GPHC stated, “Little Shailah was discharged into her mother’s arm without any obvious neurological deficits and is expected to lead a normal childhood.”
Close monitoring, however, will be done to determine any difficulty in the child’s developmental lifecycle.
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